Maternal body mass index, maneuvers, and neonatal morbidity associated with shoulder dystocia

Shoulder dystocia is associated with neonatal morbidity. Higher maternal prepregnancy body mass index is an established risk factor for shoulder dystocia, yet the relationship between maternal prepregnancy body mass index and resulting neonatal morbidity after shoulder dystocia is not well-studied. We assessed the association between body mass index and neonatal adverse outcomes following shoulder dystocia. The frequency and type of maneuvers used to resolve shoulder dystocia by maternal body mass index was compared. We conducted a retrospective cohort study of pregnant individuals who experienced a shoulder dystocia at delivery from June 2012 to July 2021 at a tertiary care center. We included singleton nonanomalous live births ≥36 weeks of gestation at a single academic medical center in the Midwestern US. The primary exposure was prepregnancy body mass index categorized as: